William Court and Nunn Court

About the service

William Court and Nunn Court is a residential care home providing personal care for ten people at the time of our inspection. The service can support up to twelve people. The purpose built home consisted of one and two-bedroom apartments, with a bathroom, kitchenette, lounge and dining area.

People’s experience of using this service and what we found

Based on our review of safe and well-led the service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right Support

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff delivered care and support tailored to people’s strengths and needs. People’s interests, abilities and wishes were promoted, ensuring people had fulfilling and meaningful everyday lives.

Right Care

Staff fully understood how to protect people from poor care, neglect and abuse. Staff completed safeguarding training and recognised and reported abuse. Staff assessed, identified and mitigated individual risks. People were supported and encouraged to take positive risks in order to achieve personal change and growth.

Right Culture

People received support and care from staff who were dedicated, kind and caring. People's quality of life was improved by the services positive, transparent culture and desire to improve. People received good quality care, support and treatment because there were enough trained staff to meet each persons’ needs and wishes. Staff ensured people and those important to them were fully involved in planning their care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 21 March 2019) and we found one breach of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve staffing. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for William Court and Nunn Court on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We were somewhat assured that the provider was promoting safety through the layout and hygiene practices of the premises. There were not enough colour coded mops and buckets in each flat. Colour coded mops and buckets are used to clean different areas of the service to reduce the risk of cross contamination. Following our visit, the provider gave us assurances that additional cleaning equipment was purchased.

We found the following examples of good practice.

¿ Appropriate measures were in place to prevent visitors from spreading infection. All visits were staggered and by appointment only. Visitors had to wear appropriate personal protective equipment (PPE) and had their temperature checked prior to entering the service.

¿ PPE was readily available for staff on each floor and clear signage was in place regarding the correct use of PPE. Staff had received appropriate infection prevention and control training. Staff wore their PPE in line with current national guidance.

¿ People who needed to self-isolate had their own dedicated staff who supported all their needs throughout the day. The movement of staff between flats had been reduced to minimise the risk of infection spread.

¿ Staff and people were taking part in regular whole home testing. People were provided with easy read and pictorial aids to support them to understand the testing process.

¿ The environment was very clean and regular cleaning took place including frequently touched surfaces. Regular infection control audits were carried out by the manager.

Further information is in the detailed findings below.

William Court and Nunn Court is a care home that provides personal care for up to twelve people with learning disabilities and or autism. The accommodation consisted of one or two-bedroom apartments, with a bathroom, kitchenette, lounge and dining area. At the time of our inspection ten people were living at the service.

People’s experience of using this service:

The outcomes for people did not fully reflect the principles and values of Registering the Right Support. Independence was promoted but opportunities for social inclusion was limited due to staffing levels provided.

Staff had not always received training to support their roles. The management team told us they were aware staff had not all received the required training identified as needed, but there was no robust action plan to address this. The management team were aware of shortfalls with staffing levels and were recruiting new staff. However, they had not ensured staffing levels consistently met people’s dependency needs.

Incident forms and other recording tools used to report behavioural incidents, were not effectively reviewed, monitored or analysed to understand people’s behaviour or to consider lessons learnt. Guidance for staff to support people at times of heightened anxiety, did not always include specific details of what staff needed to know.

Not all people could access the rear garden easily, due to there not being a ramp to support people’s mobility needs. An apartment where two people lived was the central place people and staff congregated and where the evening meal was cooked for everyone. It was not clear how the people living in this apartment, had been consulted about how their apartment was used for others.

People enjoyed the food and their nutritional needs were met. However, food stocks were low due to shopping happening once a week. The management team agreed to increase this to ensure food provisions were better maintained.

People told us they enjoyed living at the service and their only concerns were the lack of staff that impacted on them to access the community and activities of their choice. People told us staff were kind and caring and how they had developed positive relationships with them. Relatives were positive that staff understood their relations needs and were confident staff provided safe care. A professional told us how a person had been effectively supported to achieve some positive outcomes that had improved their health and wellbeing.

Information available for people was provided in easy read formats to support understanding. People could access spiritual support to meet their religious beliefs. Staff were knowledgeable about people’s needs, routines and what was important to them. The registered manager, with the involvement of people and or their relatives, had reviewed and updated guidance for staff about people’s needs. The registered manager was in the process of introducing formal review processes to ensure people were involved in their ongoing care.

People’s safety had been considered and risks had been reduced by the introduction of equipment or guidance. Staff were aware of their responsibility to protect people from known risks and avoidable harm. Safeguarding information was available for people who used the service and staff.

Medicine was managed safely. The risk to any infection was reduced by the maintenance of cleaning and hygiene standards.

People are supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were supported with any health conditions and accessed health services to maintain their health needs.

The service met the characteristics of requires improvement in most areas we inspected with good for Caring. We identified one breach of the Health and Social Care Act (Regulated Activities) Regulations 2014 around staffing. Details of action we have asked the provider to take can be found at the end of this report. More information is in the detailed findings below.

Rating at last inspection:

This was the provider’s first inspection since registration.

Why we inspected:

This was a planned inspection based on when the service was registered.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.